Testicular self-examination: Frequently asked questions

Introduction

It is common knowledge that monthly breast self-examination for women is an effective part of early breast cancer detection. For men, starting at puberty, monthly self-examination of the testicles is an effective way of getting to know this area of your body and thus detecting testicular cancer (TC) at an early, and very curable, stage.

When should I do self-examination?

Self-examination for TC is best performed after a warm bath or shower. Heat relaxes the scrotum, making it easier to spot anything abnormal.

How should I do it?

• Stand in front of a mirror. Check for any swelling on the scrotal skin.
• Examine each testicle with both hands. Place the index and middle fingers under the testicle with the thumbs placed on top. Roll the testicle gently between the thumbs and fingers; you shouldn't feel any pain when doing the examination. Don't be alarmed if one testicle seems slightly larger than the other because that is normal.
• Find the epididymis, the soft, tube like structure behind the testicle that collects and carries sperm. If you are familiar with this structure, you won't mistake it for a suspicious lump. Cancerous lumps are usually found on the sides of the testicle but can also show up on the front. Lumps in the epididymis are virtually never cancerous.

What if I find an abnormality?

If you find a lump, see a doctor right away. The abnormality may not be cancer but just an infection. If it is testicular cancer, it will spread if it is not stopped by treatment. Waiting and hoping will not fix anything.

Free-floating lumps in the scrotum that are not attached in any way to a testicle are not testicular cancer.

When in doubt, get it checked out - if only for peace of mind!

What other conditions may be important?

• Any enlargement of a testicle
• A significant loss of size in one of the testicles
• A feeling of heaviness in the scrotum
• A dull ache in the lower abdomen or in the groin
• A sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or in the scrotum
• Enlargement or tenderness of the breasts

Anything out of the ordinary should be mentioned to your GP but the following are not usually signs of testicular cancer:

• A pimple, ingrown hair or rash on the scrotal skin
• A free-floating lump in the scrotum, seemingly not attached to anything
• A lump on the epididymis or tubes coming from the testicle that feels like an extra testicle
• Pain or burning during urination
• Blood in the urine or semen

Other information

This patient information leaflet provides input from specialists, the British Association of Urological Surgeons, the Department of Health and evidence based sources as a supplement to any advice you may already have been given by your GP. Alternative treatments can be discussed in more detail with your urologist or specialist nurse.

Who can I contact for more help or information?

Oncology nurses

Uro-oncology nurse specialist
01223 586748

Bladder cancer nurse practitioner (haematuria, chemotherapy and BCG)
01223 274608

Prostate cancer nurse practitioner
01223 274608 or 01223 216897

Surgical care practitioner
01223 348590 or 01223 256157

Non-oncology nurses

Urology nurse practitioner (incontinence, urodynamics, catheter patients)
01223 274608

Urology nurse practitioner (stoma care)
01223 349800

Urology nurse practitioner (stone disease)
07860 781828

Patient advice and liaison service (PALS)

Telephone: 01223 216756
PatientLine: *801 (from patient bedside telephones only)
Email PALS

Mail: PALS, Box No 53
Addenbrooke's Hospital
Hills Road, Cambridge, CB2 2QQ

Chaplaincy and multi faith community

Telephone: 01223 217769
Email the chaplaincy

Mail: The Chaplaincy, Box No 105
Addenbrooke's Hospital
Hills Road, Cambridge, CB2 2QQ

MINICOM System ("type" system for the hard of hearing)

Telephone: 01223 217589

Access office (travel, parking and security information)

Telephone: 01223 596060